Dr. Smith's ECG Blog
SEPTEMBER 11, 2024
There are QS-waves in V1-V3 suggesting old anterior MI with persistent ST Elevation (LV aneurysm morphology), but I have written a couple papers showing that in LV aneurysm, the T-wave is not > 0.36 T/QRS Amplitude Best Distinguishes Acute Anterior MI from Anterior Left Ventricular Aneurysm. LV Aneurysm vs New Infarction?
Dr. Smith's ECG Blog
JULY 26, 2023
But the well-formed Q-wave and the presence of a normal T-wave in inferior leads led me to believe this was Old Inferior MI with persistent ST Elevation, otherwise known as inferior LV aneurysm. Anterior LV aneurysm is much easier to recognize because the Q-wave is usually a QS-wave (no R-wave at all), in at least one lead.
Dr. Smith's ECG Blog
OCTOBER 15, 2024
The EKG is diagnostic of acute inferior, posterior, and lateral OMI superimposed on “LV aneurysm” morphology. He had multiple episodes of bradycardia and nonsustained ventricular tachycardia. Patient 2 , EKG 1: What do you think? Patient 1 ’s EKG was obtained first, so it was interpreted first.
Dr. Smith's ECG Blog
MAY 19, 2020
There is sinus bradycardia with one PVC. The patient's heart had significant recovery: Echo : Estimated LVEF 32%, apical wall motion abnormality with diastolic distortion (LV aneurysm), suggestive of old MI. She then had a 12-lead: What do you think? A followup ECG was recorded 2 days later: No definite evidence of infarction.
Dr. Smith's ECG Blog
APRIL 8, 2015
Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful.
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